Clinical and experimental nephrology
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Clin. Exp. Nephrol. · Jun 2006
Use of base in the treatment of acute severe organic acidosis by nephrologists and critical care physicians: results of an online survey.
Acute severe metabolic acidosis associated with lactic acidosis or ketoacidosis can have severe detrimental effects on organ function, and might contribute to mortality. A general consensus exists that elimination of the cause of the acidosis is essential for treatment, but there is controversy concerning the use of base for the treatment of these disorders. Some physicians advocate administration of base when the acidosis is severe to prevent a decrease in cardiac output, whereas others oppose administration of base even when the acidosis is severe given the potential compromise of cardiac function. Nephrologists and critical care specialists are often the physicians developing recommendations for the treatment of severe acid-base disorders. ⋯ The results of this survey indicate that the decisions whether to use base for the treatment of acute severe metabolic acidosis, and under which circumstances, vary among physicians, and indicate the need for further studies to develop evidence-based guidelines for therapy.
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Clin. Exp. Nephrol. · Mar 2005
Risk factors for bleeding complications in percutaneous renal biopsy.
Among the complications in percutaneous renal biopsy, bleeding is the most frequent and sometimes becomes fatal. ⋯ For those who are clinically suspected of having amyloidosis or hypertension, more careful biopsy procedures and observations are necessary.
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The prevalence of end-stage renal disease (ESRD) is rising throughout the developed and developing world, although the rate of increase may be attenuating in some regions. Type 2 diabetes mellitus, often a consequence of obesity and accompanied by the metabolic syndrome, is a major cause of progressive renal disease and the increasing global burden of ESRD. ⋯ Primary and secondary prevention measures, involving screening and interventions, have demonstrated beneficial effects when appropriately designed and targeted to "high-risk" groups. If these strategies can be implemented at the societal level and compliance with the interventions is robust, it is entirely possible that the rising tide of ESRD can be converted into a receding tide of ESRD in the future.
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Clin. Exp. Nephrol. · Sep 2004
Role of mitogen-activated protein kinase in the regulation of transforming growth factor-beta-induced fibronectin accumulation in cultured renal interstitial fibroblasts.
In diabetic nephropathy, tubulointerstitial fibrosis is an important component of renal injury. Transforming growth factor (TGF)-beta is a key cytokine that is involved in the pathogenesis of tubulointerstitial fibrosis. However, signal transduction cascades of TGF-beta under high-glucose conditions remain to be clarified. We undertook this study to elucidate whether mitogen-activated protein (MAP) kinase and Smad proteins were involved in TGF-beta-induced fibronectin (FN) production under high glucose in NRK fibroblasts. ⋯ NRK fibroblasts exposed to high glucose demonstrated increased TGF-beta1-induced p38 MAP kinase activation. The FN synthesis induced by high glucose and TGF-beta1 was not affected by the Smads pathway and was not due to increased osmolarity. The enhanced activation of p38 MAP kinase may contribute to the altered fibroblast phenotype that leads to progressive diabetic nephropathy.